Hypermagnesemia

Hypermagnesemia is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • A serum magnesium >2.2 mEq/L defines hypermagnesemia.
  • Most cases of clinically significant hypermagnesemia are iatrogenic, occurring with large doses of magnesium-containing antacids or laxatives and during treatment of preeclampsia with IV magnesium. Because renal excretion is the only means of lowering serum magnesium levels, the presence of significant renal insufficiency can lead to magnesium toxicity even with therapeutic doses of these antacids and laxatives.
  • Mild, insignificant elevations in magnesium can occur in end-stage renal disease patients, theophylline intoxication, DKA, and tumor lysis syndrome.

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General Principles

  • A serum magnesium >2.2 mEq/L defines hypermagnesemia.
  • Most cases of clinically significant hypermagnesemia are iatrogenic, occurring with large doses of magnesium-containing antacids or laxatives and during treatment of preeclampsia with IV magnesium. Because renal excretion is the only means of lowering serum magnesium levels, the presence of significant renal insufficiency can lead to magnesium toxicity even with therapeutic doses of these antacids and laxatives.
  • Mild, insignificant elevations in magnesium can occur in end-stage renal disease patients, theophylline intoxication, DKA, and tumor lysis syndrome.

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